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To the Editor.–The gentlemanly editorial comment of R.N. Stauffer, MD, on Mizuguchi's article "Division of the Pyriformis Muscle for the Treatment of Sciatica" (Arch Surg 111:719, 1976) did not "fit the crime." Back pain(s) and therapy for same, even if limited to "sciatica," are very difficult to assess. Complete description of the physical findings before and after operation is important, and myelograms are actually an adjunctive procedure.
The discrepencies between the references and the thesis of the author are noteworthy. For example, Robinson (reference; Am J Surg 73:355, 1947) recommended section of the pyriformis in the absence of lumbar lesions.
The study group consisted of 14 patients who were divided into two groups described as (1) postlaminectomy and (2) osteoarthritis. Several patients in group 1 had previous operations, and perhaps all had myelograms. Only three patients in group 2 had myelograms–presumedly the same three described as having "narrow spinal
MOORE GE, STECHER K. Division of Pyriformis Muscle. Arch Surg. 1977;112(1):100. doi:10.1001/archsurg.1977.01370010102029